PROVIDENCE HEALTH & SERVICES OREGON: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PROVIDENCE HEALTH & SERVICES OREGON (EIN 51-0216587)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201333199349310628
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T17:17:02-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN911194016EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th Suite 1700AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN510216587EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE HEALTH & SERVICES - OREGONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPROVNameControl
Phone4255253985Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 Lind Avenue SW No 9016AddressLine1
CityRentonCity
StateWAState
ZIP Code980579016ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTodd HofheinsName
TitleEVP/CFOTitle
Phone4255253985Phone
Date Signed2013-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSara Elizabeth J Hyre CPAName
PTINP00235495PTIN
Phone4254544919Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRod Hochman MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11801 Lind Avenue SW No 9016AddressLine1
CityRentonCity
StateWAState
ZIP Code980579016ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3386473930GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww2.providence.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionHealthcare with special concern for the poor and vulnerable in Oregon.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees19803TotalNbrEmployees
Total Nbr Volunteers2743TotalNbrVolunteers
Total Gross UBI17344508TotalGrossUBI
Net Unrelated Business Txbl Income3132441NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year38675796ContributionsGrantsPriorYear
Contributions Grants Current Year34966074ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2256603295ProgramServiceRevenuePriorYear
Program Service Revenue CY2397230618ProgramServiceRevenueCY
Investment Income Prior Year36241093InvestmentIncomePriorYear
Investment Income Current Year62898021InvestmentIncomeCurrentYear
Other Revenue Prior Year106676444OtherRevenuePriorYear
Other Revenue Current Year101574543OtherRevenueCurrentYear
Total Revenue Prior Year2438196628TotalRevenuePriorYear
Total Revenue Current Year2596669256TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year9635621GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY7004623GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1299171785SalariesEtcPriorYear
Salaries Etc Current Year1340357818SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year3033830TotalFundrsngExpCurrentYear
Other Expense Prior Year965698773OtherExpensePriorYear
Other Expenses Current Year1119817360OtherExpensesCurrentYear
Total Expenses Prior Year2274506179TotalExpensesPriorYear
Total Expenses Current Year2467179801TotalExpensesCurrentYear
Revenues Less Expenses Prior Year163690449RevenuesLessExpensesPriorYear
Revenues Less Expenses CY129489455RevenuesLessExpensesCY
Total Assets BOY2616453424TotalAssetsBOY
Total Assets EOY2593067944TotalAssetsEOY
Total Liabilities BOY632972466TotalLiabilitiesBOY
Total Liabilities EOY629244906TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1983480958NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1963823038NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAs People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor and vulnerable in Oregon.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense879431357Expense
Grants0Grants
Revenue1054987787Revenue
DescriptionAcute Care-Inpatient: Admissions - 69,024Patient Days - 286,669OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and Stewardship OUR COMMITMENT As a not-for-profit health care ministry, Providence Health & Services - Oregon embraces our responsibility to respond to the needs of people in our communities, especially the poor and vulnerable. This commitment, this Mission rooted in God's love for all, began with the Sisters of Providence more than 150 years ago.The Heart of our MissionWe focus our community benefit outreach on four specific populations. These are low-income and uninsured people, diverse populations, older citizens, and people with behavioral needs. Our outreach can range from covering the medical bills of a husband and father disabled by diabetes, to financially supporting a nonprofit that embraces older refugees and immigrants.During these hard economic times in our neighborhoods and our nation, we reinforce our commitments to caring for the poor and vulnerable. This compassionate caring is, and always has been, the heart of our Mission. Providence Health & Services - Oregon is a not-for-profit network of hospitals, care centers, health plans, physicians, home health services, clinics and other services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago.Our facilities include: Providence St. Vincent Medical Center, Providence Portland Medical Center, Providence Milwaukie Hospital, Providence Hood River Memorial Hospital, Providence Newberg Medical Center, Providence Seaside Hospital,Providence Medford Medical Center, Providence Child Center, Providence Elderplace, Providence Benedictine Nursing Center, Providence Senior Village, Providence Seaside Extended Care, Providence Home and Community Services, Providence Health Plans, Providence Medical Group clinics, Providence Graduate Medical Education clinics, Providence North Coast clinics and Providence Hood River clinicsResearch CentersProvidence physicians, scientists and research teams participate in basic research, applied research and clinical trial research. They have achieved national recognition for their work, some of which has led to revolutionary changes in health care:*Albert Starr Academic Center for Cardiac Surgery*Center for Outcomes Research and Education*Earle A. Chiles Research Institute*Oregon Medical Laser Center*Robert W. Franz Cancer Research Center*Women and Children's Health Research CenterThe ministries of Providence in Oregon have a shared vision to create an experience of connected care for each patient. We also work to achieve the Triple Aim, which calls us to:*Improve our population's health*Give our patients the best care experience*Make sure our services are affordableIn 2012, Providence in Oregon:*Operated eight hospitals, more than 90 clinics and Oregon's largest neonatal intensive care unit*Provided primary, preventive and specialty care to nearly 1.3 million children and adults*Welcomed 10,787 babies - more than any other health system in Oregon*Cared for 279,538 emergency patients*Gave 445,655 home health and hospice visits/days of care to community residentsDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense705296617Expense
Grants0Grants
Revenue846150692Revenue
DescriptionAcute Care - Outpatient: Visits - 3,115,827See Line 4a Narrative.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense198371038Expense
Grants0Grants
Revenue237989567Revenue
DescriptionPrimary Care: Visits - 1,324,708See Line 4a Narrative.Description

Activity Other ActivityOther (3 entries)

ExpenseExpenseGrantsGrantsRevenueRevenueDescriptionDescription
2195523400263291729Long-Term Care, Homecare, Hospice, Housing & Assisted Living: LTC Patient Days - 61,267; Home & Hospice Visits - 445,655; Housing & Assisted Living Days - 141,403.Quality home care: For the fourth consecutive year, Providence Home Care in southern Oregon has been named as one of the top 500 home health agencies in the nation by HomeCare Elite, based on measures of quality and financial performance.Hospice services in rural area: Providence Hood River Memorial Hospital, a critical access facility, has expanded hospice care to serve residents in the Columbia Gorge area.
700462370046230Grants & Allocations to Community Organizations - See Schedule I
34012283040769324Physician Fees
FieldValueIRS element (for citing)
Total Of Other Program Service Exp260569246TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt7004623TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev304061053TotalOfOtherProgramServiceRev
Total Program Service Expense2043668258TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10961454NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees19803NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Karl E Fritschel CPABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4255253339TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11801 Lind Ave SW 9016AddressLine1
CityRentonCity
StateWAState
ZIP Code980579016ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (51 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Lucille Dean SP
Chair of the Board0.2012.90XX000
M Adrian Davis LCM -Dcd 512
Director0.202.70X000
Mary Corita Heid RSM
Director0.205.40X000
Michael A Stein
Director0.006.10X0183000
Michael Holcomb
Director0.007.50X0190500
Dana A Rasmussen
Director0.205.80X0183000
James S Roberts MD
Director0.208.90X0205000
Peter J Snow
Director0.205.60X0205000
Jeffrey B Clode MD -Thru 612
Director0.206.90X087500
Sallye Liner
Director0.204.00X0153000
Owen B Robinson
Director0.205.30X0153000
Cheryl M Scott
Director0.204.50X0150000
Ellen L Wolf
Director0.207.60X0153000
Isiaah Crawford
Director0.204.00X0150000
Martha Diaz Aszkenazy
Director0.207.60X0151750
Kirby McDonald
Director0.204.50X0151750
Dave Olsen
Director0.205.40X0151750
Charles Chuck Watts
Director0.206.00X0151750
John Nordstrom -Thru 712
Director0.200.60X000
John F Koster MD
President/CEO PH&S0.2053.80X04069812382715
Jeffrey W Rogers
Corporate Secretary0.2049.80X0623631319793
Todd Hofheins
EVP/CFO0.2059.80X055572540426
Gregory Van Pelt
EVP/OR. Region60.000.00X01193691434439
Shelly M Handkins
CFO/OR. Region50.000.00X0483207304167
Michael L Butler
Group President0.0065.0001406031890844X
Rod Hochman MD
Group President0.0065.0001438710332177X
David T Underriner
CEO/PSA0.0040.000583400431860X
John V Fletcher
VP/Operations Support0.0055.0001575373259253X
Janice J Jones
SVP/CAO0.0055.0001031256204051X
Myron Berdischewsky MD
SVP/CMQO0.0060.0002359308166605X
Cindra R Syverson
SVP/CHRO0.0060.000562260220668X
Terry L Smith
SVP/Management Svcs.0.0060.0001012414349119X
Craig L Wright MD
CE/OR. Ambulatory Clin. Svc.0.0060.000773915392058X
Ray Williams
SVP/Physician Svcs0.0055.0001240435162999X
Cindy Strauss
SVP/Chief Legal Officer0.0055.000621810205922X
Phil Jackson
VP/Physician Svc. & PMG0.0055.000609104157689X
John O Mudd
SVP/Mission Leadership0.0055.000505083114350X
Claudia Haglund
VP/Governance & Spons.0.0050.000501085219670X
Joel S Gilbertson
VP/Gov't & Public Affairs0.0060.000456934105567X
Joseph Siemienczuk MD
CEO/PMG0.0040.000452069143472X
Janice Burger
CEO/SVMC0.0040.000386625235136X
Orest Holubec
VP/ Communications0.0055.00041049953484X
Debbie Burton
VP/CNO0.0065.000405452233827X
Theron Park
CEO/PPMC0.0040.00037620662872X
Blair D Halperin
Physician - Cardiology40.000.00664423033766X
Tyler J Gluckman
Physician - Cardiology40.000.00763566029130X
Daniel S Oseran
Physician - Cardiology40.000.00664074032129X
Erin J Allen
PMG Dermatology40.000.00876203043520X
Walter J Urba
Clin.Research Admin.40.000.00784305065216X
Eugene Al Parrish
Former SVP/RCE Alaska Region0.000.00048551957205X
John Kenagy
Former VP/CIO0.000.00085867414815X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3752571TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs25220228TotalReportableCompFrmRltdOrgs
Total Other Compensation6698944TotalOtherCompensation
Number Individuals GT100 K2094NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Oregon Emergency Physicians PC
9155 Barnes Rd Ste 420PortlandOR97225Medical Services34006794
Andersen Construction Co Inc
6712 N Cutter CirPortlandOR97217Construction Services25401370
Cross Country Travcorps Incorporated
File 50941Los AngelesCA900740941Outside Staffing12661085
Anesthesia Assoc Northwest LLC
6400 SE Lake Rd Ste 130PortlandOR972222129Medical Services10388943
The Oregon Clinic PC
847 NE 19th Avenue Ste 300PortlandOR972322684Medical Services9450009
FieldValueIRS element (for citing)
Number Of Contractors GT100 K475NumberOfContractorsGT100K
Federated Campaigns4238FederatedCampaigns
Fundraising Events103251FundraisingEvents
Related Organizations16501199RelatedOrganizations
Government Grants12841898GovernmentGrants
All Other Contributions5515488AllOtherContributions
Noncash Contributions96976NoncashContributions
Total Contributions34966074TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Acute Care/Inpatient90009910400961011040096101
Acute Care/Outpatient621400834207685834207685
LTC/HomeCare/Hospice621610248102961248102961
Primary Care621110234630488234630488
Physician Fees9000994019338340193383
FieldValueIRS element (for citing)
Total Program Service Revenue2397230618TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19886816TotalRevenueColumn
Exclusion$19,886,816ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column694349TotalRevenueColumn
Exclusion$694,349ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real26285401Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real17921588Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real8363813Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column8363813TotalRevenueColumn
Exclusion$8,363,813ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities779670870Securities
Other3452280Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities738159528Securities
Other1952417Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities41511342Securities
Other1499863Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column43011205TotalRevenueColumn
Exclusion$43,011,205ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events55046GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events103251CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses111071FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-56025TotalRevenueColumn
Exclusion-$56,025ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming2450GrossIncomeGaming
Gaming Direct Expenses208GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column2242TotalRevenueColumn
Exclusion$2,242ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory45944294GrossSalesOfInventory
Cost Of Goods Sold31659862CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column14284432TotalRevenueColumn
Related Or Exempt Function Income11471020RelatedOrExemptFunctionIncome
Unrelated Business Revenue2813412UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Contracted Services9000992527200625272006
Laboratory6215001453109614531096
Cafeteria Revenue72221013996779$13,996,779

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column24485851TotalRevenueColumn
Related Or Exempt Function Income9215455RelatedOrExemptFunctionIncome
Exclusion$15,270,396ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue78285732TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2596669256TotalRevenueColumn
Related Or Exempt Function Income2443189099RelatedOrExemptFunctionIncome
Unrelated Business Revenue17344508UnrelatedBusinessRevenue
Exclusion$101,169,575ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total7004623Total
Program Services7004623ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6099390Total
Management And General6099390ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1016419618Total
Program Services890403688ProgramServices
Management And General126015930ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total85259449Total
Program Services74378028ProgramServices
Management And General10881421ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total146870201Total
Program Services129739706ProgramServices
Management And General17130495ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total85709160Total
Program Services74770344ProgramServices
Management And General10938816ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1075144Total
Program Services217379ProgramServices
Management And General857765ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total28505Total
Management And General28505ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total231472Total
Management And General231472ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1528262Total
Management And General1528262ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total325090912Total
Program Services212694229ProgramServices
Management And General112396683ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total8324568Total
Program Services1853121ProgramServices
Management And General6471447ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total44895977Total
Program Services27282537ProgramServices
Management And General17613440ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total43862246Total
Program Services5521408ProgramServices
Management And General38340838ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total48289953Total
Program Services34457901ProgramServices
Management And General13832052ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total5216833Total
Program Services3971340ProgramServices
Management And General1245493ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2702228Total
Program Services1762798ProgramServices
Management And General939430ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6218584Total
Program Services6218584ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total37548783Total
Management And General37548783ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total101709391Total
Program Services92969108ProgramServices
Management And General8740283ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total8859052Total
Program Services8504600ProgramServices
Management And General354452ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies337520993337402305118688
Provider Tax Expense7019483170194831
Bad Debts5524159855241598
Research Expense51852375185237

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total16092791Total
Program Services3894893ProgramServices
Management And General9164068ManagementAndGeneral
Fundraising3033830Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2467179801Total
Program Services2043668258ProgramServices
Management And General420477713ManagementAndGeneral
Fundraising3033830Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY114650BOY
EOY1925346EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY60572429BOY
EOY87970232EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY999977BOY
EOY2719357EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY289811342BOY
EOY298013045EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY3956288BOY
EOY3434252EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY35832779BOY
EOY35149498EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY24399659BOY
EOY24956608EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2685121360LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1509110252LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1209566160BOY
EOY1176011108EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY835693287BOY
EOY800753018EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY142280BOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY82445818BOY
EOY83450817EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY4452069BOY
EOY3201817EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY68466686BOY
EOY75482846EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2616453424BOY
EOY2593067944EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY221057350BOY
EOY232731831EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY24885041BOY
EOY27441149EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY317970000BOY
EOY311990000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4967098BOY
EOY6657984EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY1474931BOY
EOY1351619EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY62618046BOY
EOY49072323EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY632972466BOY
EOY629244906EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1929703471BOY
EOY1906061097EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY26040932BOY
EOY29571341EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY27736555BOY
EOY28190600EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1983480958BOY
EOY1963823038EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2616453424BOY
EOY2593067944EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses129489455ReconcilationRevenueExpenses
Reconciliation Unrealized Invest12582392ReconciliationUnrealizedInvest
Reconcilation Other Changes-161729767ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Mailings Members$17,766MailingsMembersAmount
Publications Or Broadcast1PublicationsOrBroadcast
Publications Or Broadcast$17,126PublicationsOrBroadcastAmount
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$135,020GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$270,374DirectContactLegislatorsAmount
Rallies Demonstrations1RalliesDemonstrations
Rallies Demonstrations$21,613RalliesDemonstrationsAmount
Other Activities0OtherActivities
Total Lobbying Expenditures IIB461899TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationLobbying activity included: * Analysis of early draft legislation for 2012 Oregon Legislative Session * Visits, calls, e-mails, and letters to state legislators, legislative bodies, and members of Congress * Visits, calls, e-mails, and letters to legislative staff and government officials * Discussions and meetings with lobbyists * Ongoing analysis of legislation during the 2012 Legislative Session * Attending state, federal and local government hearings and meetings in the Portland area Ballot measures * During 2012, Providence in Oregon did not engage in discussions on any state and local government ballot measures. * We contributed financially to school district and community health ballot measures, but did not engage in advocacy. Issues advocacy Major issues supported, opposed, or commented on to legislators/government officials/staffers by Providence in Oregon, in 2012 include: * Employer/employee relations issues * Health insurance mandates * Health insurer regulatory, finance and legislative issues * Hospital regulatory, finance and legislative issues * Long term care facilities regulatory, finance and legislative issues * Medicaid health care transformation and coordinated care organizations * Oregon health insurance exchange * Health care workforce issues * Provider reimbursement and alternative payment methods * Pharmacy benefit management issues * Pharmacy prescribing practices and coverage * Cultural competency and eliminating disparities in health care * Patient privacy and notification * Mental health integration and benefit * Community health needs assessment * Local government: - Transportation and economic issues - Community outreach and education - Paid sick leave - Water fluoridationExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis26601731InvestmentCostOrOtherBasis
Other Cost Or Other Basis83073051OtherCostOrOtherBasis
Book Value109674782BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis3590000InvestmentCostOrOtherBasis
Other Cost Or Other Basis1190005572OtherCostOrOtherBasis
Depreciation621776501Depreciation
Book Value571819071BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis50796298OtherCostOrOtherBasis
Depreciation32782884Depreciation
Book Value18013414BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis2598InvestmentCostOrOtherBasis
Other Cost Or Other Basis805104853OtherCostOrOtherBasis
Depreciation663301294Depreciation
Book Value141806157BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis525947257OtherCostOrOtherBasis
Depreciation191249573Depreciation
Book Value334697684BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1176011108TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
Resident Trust Funds$670,576
LT Asset Retirement Obligation - FIN 47$3,402,890
Third Party Reserves$22,621,766
Bond Premium Discount$5,229,952
Capitalized Lease Obligations$102,525
Pension Benefit Obligation$17,044,614
FieldValueIRS element (for citing)
Total Of Amounts49072323TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X, Line 2:ReturnReference
ExplanationThe Health System recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Montessori AuctionNameOfEvent1
Gross Receipts Event1158297GrossReceiptsEvent1
Charitable Contributions Event1103251CharitableContributionsEvent1
Gross Revenue Event155046GrossRevenueEvent1
Rent Facility Costs Event12000RentFacilityCostsEvent1
Food And Beverage Event17868FoodAndBeverageEvent1
Other Direct Expenses Event1101203OtherDirectExpensesEvent1
Gross Receipts Total158297GrossReceiptsTotal
Charitable Contributions Total103251CharitableContributionsTotal
Gross Revenue Total Events55046GrossRevenueTotalEvents
Rent Facility Costs Total Events2000RentFacilityCostsTotalEvents
Food And Beverage Total Events7868FoodAndBeverageTotalEvents
Other Direct Expenses Total Events101203OtherDirectExpensesTotalEvents
Direct Expense Summary Events111071DirectExpenseSummaryEvents
Net Income Summary-56025NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense94649000TotalCommunityBenefitExpense
Net Community Benefit Expense94649000NetCommunityBenefitExpense
Percent Of Total Expense0.03920PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense261869000TotalCommunityBenefitExpense
Direct Offsetting Revenue193790000DirectOffsettingRevenue
Net Community Benefit Expense68079000NetCommunityBenefitExpense
Percent Of Total Expense0.02820PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense1648000TotalCommunityBenefitExpense
Direct Offsetting Revenue980000DirectOffsettingRevenue
Net Community Benefit Expense668000NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense358166000TotalCommunityBenefitExpense
Direct Offsetting Revenue194770000DirectOffsettingRevenue
Net Community Benefit Expense163396000NetCommunityBenefitExpense
Percent Of Total Expense0.06770PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense4928583TotalCommunityBenefitExpense
Direct Offsetting Revenue708691DirectOffsettingRevenue
Net Community Benefit Expense4219892NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense25072822TotalCommunityBenefitExpense
Direct Offsetting Revenue6084318DirectOffsettingRevenue
Net Community Benefit Expense18988504NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense22252258TotalCommunityBenefitExpense
Direct Offsetting Revenue11225027DirectOffsettingRevenue
Net Community Benefit Expense11027231NetCommunityBenefitExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense21584508TotalCommunityBenefitExpense
Net Community Benefit Expense21584508NetCommunityBenefitExpense
Percent Of Total Expense0.00890PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense3751337TotalCommunityBenefitExpense
Direct Offsetting Revenue642469DirectOffsettingRevenue
Net Community Benefit Expense3108868NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense77589508TotalCommunityBenefitExpense
Direct Offsetting Revenue18660505DirectOffsettingRevenue
Net Community Benefit Expense58929003NetCommunityBenefitExpense
Percent Of Total Expense0.02440PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense435755508TotalCommunityBenefitExpense
Direct Offsetting Revenue213430505DirectOffsettingRevenue
Net Community Benefit Expense222325003NetCommunityBenefitExpense
Percent Of Total Expense0.09210PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense20150TotalCommunityBuildingExpense
Direct Offsetting Revenue1350DirectOffsettingRevenue
Net Community Building Expense18800NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense259065TotalCommunityBuildingExpense
Direct Offsetting Revenue51150DirectOffsettingRevenue
Net Community Building Expense207915NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense60683TotalCommunityBuildingExpense
Direct Offsetting Revenue20810DirectOffsettingRevenue
Net Community Building Expense39873NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense154671TotalCommunityBuildingExpense
Direct Offsetting Revenue36300DirectOffsettingRevenue
Net Community Building Expense118371NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense42078TotalCommunityBuildingExpense
Direct Offsetting Revenue1600DirectOffsettingRevenue
Net Community Building Expense40478NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense178632TotalCommunityBuildingExpense
Direct Offsetting Revenue11319DirectOffsettingRevenue
Net Community Building Expense167313NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense715279TotalCommunityBuildingExpense
Direct Offsetting Revenue122529DirectOffsettingRevenue
Net Community Building Expense592750NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$55,241,598BadDebtExpenseAmount
Amount Reimbursed By Medicare759955000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare890022000CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-130067000MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 Oregon Outpatient Surgery CenterBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityAmbulatory Surgery CenterDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.51000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.49000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities8NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (8 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursFacility Reporting GroupFacilityReportingGroupCritical Access HospitalCriticalAccessHospitalOtherOther
Providence Portland Medical Center
14805 NE Glisan StPortlandOR97213XXXXA
Providence St Vincent Medical Center
29205 SW Barnes RdPortlandOR97225XXXXA
Providence Milwaukie Hospital
310150 SE 32ndMilwaukieOR97222XXXA
Providence Hood River Mem Hospital
4811 - 13th StreetHood RiverOR97031XXAX
Providence Seaside Hospital
5725 S Wahanna RdSeasideOR97138XXAXNursing Facility
Providence Newberg Medical Center
61001 Providence DriveNewbergOR97132XXXA
Providence Medford Medical Center
71111 Crater Lake AvenueMedfordOR97504XXXA
Providence Willamette Falls Med Ctr
81500 Division StreetOregon CityOR97045XXA

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Providence Health & Services - OregonBusinessNameLine1
FieldValueIRS element (for citing)
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities25NumberOfOtherFacilities

Other Facilities OtherFacilities (25 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Prov Portland Med Ctr Dialysis Unit
4805 NE Glisan StPortlandOR97213ESRD-End Stage Renal Disease
Providence St Vincent Kidney Dialysis
9450 SW Barnes Rd Suite 125PortlandOR97225ESRD-End Stage Renal Disease
PHRMH Ray Yasui Dialysis Center
1125 May AvenueHood RiverOR97031ESRD-End Stage Renal Disease
Providence Home Health
6410 NE Halsey Suite 200PortlandOR97213Home Health Agency
Prov Benedictine Nursing Center HHA
570 S Main StMt AngelOR97362Home Health Agency
Providence Home Care
2033 Commerce DriveMedfordOR97504Home Health Agency
Providence Hospice
6410 NE Halsey Suite 300PortlandOR97213Hospice
Providence Medford Hospice
2033 Commerce DriveMedfordOR97504Hospice
Surgery Center at Tanasbourne
18650 NW Cornell Rd Suite 110HillsboroOR97124Ambulatory Surgery Center
Center for Specialty Surgery
11782 SW Barnes Rd 200 Bldg CPortlandOR97225Ambulatory Surgery Center
Oregon Outpatient Surgery
7300 SW Childs RdTigardOR97224Ambulatory Surgery Center
Providence Child Center
860 NE 47th AvePortlandOR97213Nursing Facility
Providence Benedictine Nursing Center
540 S Main StMt AngelOR97362Nursing Facility
Providence Seaside Hospital
725 S Wahanna RdSeasideOR97138Nursing Facility
Providence Benedictine Orchard House
550 S Main StMt AngelOR97362Assisted Living Facility
Providence Brookside Manor
1550 Brookside DrHood RiverOR97031Assisted Living Facility
Prov Elderplace in Irvington Village
420 NE MasonPortlandOR97211Assisted Living Facility
Providence Elderplace in Glendover
13007 NE Glisan StPortlandOR97230Residential Care Facility
Providence Elderplace in Cully
5119 NE 57th AvePortlandOR97218Residential Care Facility
Providence Brookside Memory Care
1550 Brookside DrHood RiverOR97031Residential Care Facility
Providence Willamette Falls Hospice
1505 Division StreetOregon CityOR97045Hospice Services
Providence WF - Canby Place
200 S Hazel Dell WayCanbyOR97013Urgent Care & Diagnostic Imaging
Providence WF Med Grp-OR City
1510 Division StreetOregon CityOR97045Primary Care Spine Center/General Surgery
Providence WF MedGrp-Sunnyside
9775 SE Sunnyside RoadClackamasOR97015Primary Care & Occupational Health
Proviodence WF Med Group - West Linn
18676 Willamette Dr Suite 100West LinnOR97068Primary Care

Form990 Schedule H Part VI Form990ScheduleHPartVI (35 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 55241598.
Part II: COMMUNITY BUILDING ACTIVITIES:Basic needs including food security and housing:Providence recognizes that the social determination of health needs includes adequate housing, food, transportation, utilities and primary education. These deficits fall disproportionately on low-income and multicultural populations and therefore Providence has aligned its community building and diversity programs to intersect with and advise our community benefit giving. Oregon ranks third in homelessness per capita according to the U.S. Department of Housing and Urban Development Lack of adequate housing contributes to poor health; therefore, Providence supports a number of not-for-profit community organizations that help homeless people or work to prevent homelessness. Providence is the only health system asked to participate on the 10 Year Plan Homelessness Reset Committee. In addition, we partner with organizations in multiple Oregon communities that provide or support low-income housing. Some important partners include: Central City Concern, St. Vincent De Paul, Catholic Charities, Transition Projects Incorporated, the Good Neighbor Center, Neighborhood Partnership Fund, Portland Rescue Mission, Share Outreach Vancouver and West Women's Shelter.Providence has been a leader in recognizing the significant impact of hunger on the health and well-being of all residents in the state. Oregon ranks as one of the five "hungriest states," with nearly 65% of eligible children qualifying for free or reduced lunches. Providence works with the Oregon Food Bank, The Children's Nutrition Network, The Governor's Task Force to End Hunger and Farmer's Ending Hunger, Oregon childhood hunger task force, as well as numerous food pantries in communities we serve. Economic Development:Economic development has an important impact on available housing and services for the underserved. An economically depressed area cannot easily support and care for the vulnerable. Providence looks for partnerships with like-minded organizations that will encourage a stable and strong economy. We participate in local and state organizations in each of our ministries, as well as provide executive leadership to city, county and state boards. Support for Healthy Lives and Healthy Communities:It is critical that such needs as after school programs, neighborhood support groups and violence prevention be identified and addressed in communities. We have involved public and private partners such as Self-Enhancement, Inc. as well as the Portland Trailblazers and The Portland Timbers in collaborative health initiatives. In addition, we have many not-for-profit community partners with whom we work and support financially to reach populations who need these types of services. Leadership Development and Training for Community Members and Youth:In this area, Providence has put a strong focus on diverse and low-income communities. For example, for some years we have provided scholarships for youth in multicultural and diverse populations, including Asian, African-American and Hispanic communities. Community partners include: Self Enhancement Incorporated, Hood River School District, De La Salle North School and Rosemary Anderson High School. Building Health Equity and Collaboration: Providence has long known that, while we can do a great deal to help our communities, we often can get the best results in meeting health needs, and those basic needs that contribute to or affect health, by aligning with other organizations that have an established presence and expertise. Throughout our history, we have sought like-minded partners with a mission to care for the vulnerable in the communities we serve. During 2012, we continued our financial support to an array of diverse organizations that are intent on building collaborative programs that will meet community health and build health equity. These include: the African-American Health Coalition, Asian Muslims in Need, Catholic Charities, Jefferson Regional Health Alliance, Asian Health and Service Center, La Clinica del Carinho, United Way of Jackson County and many more. In addition, Providence's Office of Community Services and Development meets regularly with the head of the state office of Health Equity and Diversity. Community Health Improvement Advocacy:In keeping with our strong commitment to social justice, Providence is an advocate for those among us who do not have a voice in policy development and community decision making. During 2012, we worked with Community Connections, Upstream Public Health, Public Health Institute, Community Health Partnerships, El Program Hispano, Ecumenical Ministries of Oregon, Northwest Health Foundation, Oregon Primary Care Association, NAMI, Office of Health Equity and Ride Connection, among others, to ensure that the needs of those we serve have been articulated to policy makers. We actively supported initiatives to improve provider cultural competence in care giving with required continuing education courses. We have a responsibility to care for people who come to us for services and also to seek out the unmet needs of people who lack basic essentials every day. As a not-for-profit health care system, Providence Health & Services reinvests its income into the communities we serve. We partner with local organizations to help improve health and quality of life for those who are poor, marginalized and vulnerable. To ensure that we use our resources responsibly - where they can help those most in need - we attempt to match our giving to areas of greatest need, as identified in our Oregon Community Health Needs Assessment. We invite you to review how were working with our community partners to ease some of these greatest needs per our 2012 Oregon Region Community Benefit report: Access to mental health careThrough a unique partnership, George Fox University and Providence Newberg Medical Center are making mental health counseling, therapy and consultations available to low-income and uninsured Yamhill County residents. Access to primary medical careWhen people don't have a family physician, they often turn to emergency departments for care when they have pain, chronic illnesses or non-life-threatening injuries. Providence is working with organizations throughout Oregon to redirect people from expensive emergency departments to more appropriate and more affordable clinics where they can get preventive and primary care.Access to dental careMedical Teams International is known for providing health care services to impoverished people around the world. In Oregon, the organization is partnering with Providence to bring free or low-cost dental care to adults and children who can't pay for treatment. The mobile dental van brought dentistry to people at two Providence hospitals last year, and we're adding a new site in 2013.Access to basic needs: foodWhen Providence Milwaukie Hospital opted to turn an unused plot of ground into community gardens, they had no idea how enthusiastically their staff would care for the gardens or how many pounds of fresh vegetables would soon be filling plates of families in need in Clackamas County.Access to basic needs: transportationWith one easy phone call, homebound seniors in south Clatsop County can get a car ride to a medical or dental appointment, to the pharmacy or even to the grocery store. In 2012, Providence volunteers drove seniors more than 16,300 miles.Workforce Development:Providence provided financial support to the De La Salle North Catholic High School, Albertina Kerr, De Paul Industries, University of Portland, Portland State University, Hood River County Health Department, the Oregon Center for Nursing, POIC and a workforce development initiative in Oregon City, all of which are working to enhance communitywide workforce issues in various parts of Oregon.
Part III, Line 4: Bad Debt expense consist of actual write off of accounts sent to collection, recovery of collections and an estimated amount based on outstanding AR. The charity policy states that Providence makes all reasonable attempts to confirm that patients are not eligible for assistance programs prior to collection agency assignment (Refer to the Oregon Policy "Collection Practices for Financial Assistance Patients"). In regards to outstanding AR for the hospitals:1. The process takes into account the adjustments and payments that have already occurred. The process then valuates the responsibility as to the Insurance Responsibility and Patient Responsibility. 2. Historical Write-Off percentages are applied, at the account level, for the Insurance and Patient balance on the account. All of the un-insured is considered to be Patient Balance since no insurance payments are expected on those accounts.3. The Patient Responsibility is further dissected into Bad Debt and Charity. Bad Debt is calculated on the patient balances for all financial classes using current and historical percentages. 4. The difference of patient balance identified as Bad Debt and the remaining balance is deemed and accrued as Charity.
Part III, Line 8: It is Providence's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue.
Part III, Line 9b: Billing and Collection Practices1. Providence makes all reasonable attempts to confirm that patients are not eligible for assistance programs prior to collection agency assignment. 2. Providence activity prior to transferring an account - Prior to transfer to a collection agency, Providence will send a minimum of 3 statements and make two phone attempts to the patient at the address and phone number provided by the patient. Statements and communications will inform the patient of their financial responsibility and of Financial Assistance. 3. In cases where a voluntary trust deed has secured a Providence debt, Providence does not execute a lien that forces the sale, vacancy or foreclosure of an assistance patient's primary residence to pay for outstanding medical bills.
Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care.
Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients.
Part VI, Line 4: COMMUNITY INFORMATION:Providence Health & Services in Oregon serves both urban and rural areas throughout a geographically diverse state, including with hospitals, health plans, physicians, clinics, home health services, long-term care and affiliated health services. Three of our hospitals in Oregon are rural and five are in urban settings; they range in size from 25 beds to 523 beds (licensed). Of our 94 clinics, six are safety nets and many more provide a significant proportion of care to underserved populations. We continue our commitment to acute behavioral health care and have one of the only units for children less than 12 years in the entire state. We have the only long-term care facility for medically fragile children in the Pacific Northwest.Out of a total population of more than 3.87 million in Oregon:* 625,594 or 16% are covered by Medicare compared to a national average of 15%.* 665,000 or 17% are covered by Medicaid.* An estimated 633,100 or 19% non-elderly people were uninsured. All of our hospitals, clinics and other facilities are open to these populations. Below are some quick facts:* About 60% of the patients served by Providence Oregon's six safety net clinics are uninsured or on Medicare or Medicaid. * Medicare represents about 16% of Oregon's population, but in 2012, 41.3% of the patient revenues at our eight hospitals were Medicare.* Providence provided 23% of all charity care in Oregon during 2012 - more than our entire market share of 20% in the state. * Providence facilities charity as a percentage of gross charges averaged 6.5% compared to the state average of 4.7%. * Almost all the children at Providence Child Center are covered by Medicaid.
Part VI, Line 5: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.In each of the communities where we serve, our ministries are actively involved with public, private and other health systems in working towards better health outcomes for the entire community. Examples of this include: participation by all Portland area hospitals and all four county health departments in a single collaborative community health needs assessment. In addition, with working as a founder and ongoing partner of Portland Project Access NOW, Providence facilities represent four of fourteen participating hospitals and 3,300 providers who agree to provide needed medical care to Oregon community members with low incomes and with urgent needs. Providence's participation and support helps to ensure that this is achievable. Another example of our collaborative participation is in Hood River County, where Providence Hood River is working with a collaboration of community agencies to form a Project Access model that is called Gorge Access Project (GAP). In addition, we still are home to the county's community health collaborative, MOCHA, which brings together the hospital, the schools, the growers, the public health department, community health center and private providers to identify and work on community health needs in a collaborative manner.
Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:Providence Health & Services owns or operates 32 general acute care hospitals, three ambulatory care centers, five medical groups, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center and Montessori school, a high school, a university, 13 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 21 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Everett, Seattle, Edmonds, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.The charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for the poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Our responsibility to stewardship drives us to a standardized approach to supply chain so that we can deliver excellent patient care while reducing the cost of delivered supplies. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence ministries are empowered to apply these policies to meet the local needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. As an integrated health system, Providence Health & Services - Oregon Region and Providence Health Plans (based in Oregon) provide extensive services that support and promote the health needs of the communities we serve. In 2011, Providence Oregon provided more than $215 million in community benefits and charity care services including: free and reduced-cost medical care; health services for underserved populations; Oregon Health Plan (Medicaid) and government sponsored medical care (such as OMIP, the Oregon high risk insurance pool); medical education and research; and community health grants and donations. These contributions and benefits to our Oregon communities are shared between our eight hospitals, our clinical programs and Providence Medical Group, and the Providence Health Plan. Throughout our more than 155-year-history, Providence has responded to community need, with special emphasis on helping the most vulnerable. In 2011, Providence Oregon provided more than $4 million in direct grants of support to at least 123 not-for-profit organizations and service agencies throughout Oregon. Thousands of adults and children received help and support through these grants, donations and community outreach. Our areas of focus include primary care and new models of team-based care delivery for uninsured, low-income and culturally diverse populations, as well as access to behavioral health care for underserved populations. We also help provide palliative care and safety net health care services for underserved populations.Providence in Oregon collaborates with community partners to help manage the cost of health care and change the way patients are cared for in our community. We believe patient-centered, team-based primary care is the foundation of health care transformation. Disparities are a feature of health care in Oregon as they are nationally. Providence's integrated delivery of care in Oregon allows us to provide leadership in developing new clinical models to coordinate care, standardize processes and improve patient outcomes. Providence is developing new patient centered primary care home models of health care delivery in Portland using employed physicians in partnership with Providence Health Plans, other commercial insurers and the Medicaid population. We currently have medical home models in 19 sites throughout the state. Many of these sites are targeted at underserved and high risk populations. Within Oregon, Providence has been an active participant in shaping the transformation of the state's health care system. Providence leaders were selected by the governor to participate in workshops that will help define the details of coordinated care organizations and make additional recommendations to the 2012 legislative session. Providence is already making changes internally and working with other health systems and community partners to begin this transformation.
OR,WA,CA,MT,AKReports Filed With StatesPart VI, Line 7
See belowPart V, Line 8 Facility Reporting Group A
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 1 -- Providence Portland Medical CenterPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 1 -- Providence Portland Medical CenterPart V, Section B, line 20d:
Facility 1 -- Providence Portland Medical CenterPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 2 -- Providence St. Vincent Medical CenterPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 2 -- Providence St. Vincent Medical CenterPart V, Section B, line 20d:
Facility 2 -- Providence St. Vincent Medical CenterPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 3 -- Providence Milwaukie HospitalPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 3 -- Providence Milwaukie HospitalPart V, Section B, line 20d:
Facility 3 -- Providence Milwaukie HospitalPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 4 -- Providence Hood River Mem. HospitalPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 4 -- Providence Hood River Mem. HospitalPart V, Section B, line 20d:
Facility 4 -- Providence Hood River Mem. HospitalPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 5 -- Providence Seaside HospitalPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 5 -- Providence Seaside HospitalPart V, Section B, line 20d:
Facility 5 -- Providence Seaside HospitalPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 6 -- Providence Newberg Medical CenterPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 6 -- Providence Newberg Medical CenterPart V, Section B, line 20d:
Facility 6 -- Providence Newberg Medical CenterPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 7 -- Providence Medford Medical CenterPart V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 7 -- Providence Medford Medical CenterPart V, Section B, line 20d:
Facility 7 -- Providence Medford Medical CenterPart V, Section B, line 22:
Brochures given to every uninsured patient at check in, web-sites, all materials in 4 languages, all call center and self pay follow-up staff trained in explaining and offering charity applications, collection agencies contracts require them to offer charityFacility 8 -- Providence Willamette Falls Med. Ctr.Part V, Section B, line 14g:
The hospital used the average of the largest negotiated commerical insurance rate.Facility 8 -- Providence Willamette Falls Med. Ctr.Part V, Section B, line 20d:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (58 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Providence St Vincent Medical Foundation
PO Box 13993PortlandOR97213930575982501(c) 31446117Community Health Support
Providence Portland Medical Foundation
4805 NE GlisanPortlandOR97213931231494501(c) 31326116Community Health Support
Providence Child Center Foundation
830 NE 47thPortlandOR97213930800140501(c) 3415911Community Health support
Virginia Garcia Memorial Clinic
PO Box 568CorneliusOR97113930717997501(c) 3390000Community Health Support
Providence Community Health Foundation
1111 Crater Lake AveMedfordOR97504930692907501(c) 3332530Community Health Support
Luke Dorf Inc
8915 SW Center StTigardOR97223930685734501(c) 30Support community Mental Health263650FMVReal Property
Providence Newberg Foundation
1001 Providence DriveNewbergOR97132930889144501(c) 3250316Community Health Support
Providence Milwaukie Foundation
10150 SE 32ndMilwaukieOR97222943079515501(c) 3222678Community Health Support
Providence Hood River Foundation
811 13th StHood RiverOR97031930921990501(c) 3172230Community Health Support
Providence Benedictine Nursing Center Fndn
540 S Main StMt AngelOR97362911940286501(c) 3151551Community Health support
Central City Concern
232 NW Everett StPortlandOR97209930728816501(c) 3137680Family alcohol and drug free Comm Housing
Project Access Now
1311 NW 21st AvePortlandOR97296208928388501(c) 31350002010/2011 Stakeholder Contribution
Oregon Health Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109501(c) 3131289Donation Partnership Project
Providence Willamette Falls Foundation
1500 Division StOregon CityOR97225931003750501(c) 3123081Community Health support
Medical Teams International
PO Box 10PortlandOR97207930878944501(c) 3120000Great Adventure Dinner and Auction
Providence Seaside Foundation
725 S Wahanna RdSeasideOR97138930927320501(c) 3111073Community Health Support
Legacy Emanuel Hospital
PO Box 5939PortlandOR97228930386823501(c) 3100000Cares NW program
The Oregon Community Foundation
1221 SW Yamhill St Suite 100PortlandOR97205237315673501(c) 3100000Grants for community health needs assessment
United Way Columbia-Willamette
619 SW 11th Ave Suite 300PortlandOR97205930582124501(c) 375000Community Health Support
Hood River County Health Department
1109 June StHood RiverOR97031936002297Government70880School health services
Southwest Community Health Clinic
7754 SW Capital HwyPortlandOR97219743050497501(c) 353800Support for chronic disease mgmt pilot project
Catholic Charities
231 SE 12th AvePortlandOR97214930386801501(c) 350630Sponsorship of El Programa Hispano
Oregon Health Authority
800 NE Oregon St Suite 550PortlandOR97232936001752Government45000Support for the study of community health work
City of Hood River
PO Box 27Hood RiverOR97031936002186Government40000Community Health support
NW Parish Nurse Ministries
2801 N Gantenbein Ave Room 1072PortlandOR97227943180955501(c) 340000Support for promoting Health and Wellness
Volunteers of America
3910 SE Stark StPortlandOR97214930395591501(c) 335000Community Health Support
Clackamas County Dept of Health Housing
2051 Kaen RoadOregon CityOR97045930626175Government31000H3S RN Crisis Clinic support
Foundation for Medical Excellence
One SW Columbia St Suite 860PortlandOR97258930632522501(c) 327500Community Health support
Columbia Gorge Community College
400 East Scenic DriveThe DallesOR97058930700843501(c) 326600Nursing occupations program
Clatsop Community College
1651 Lexington AveAstoriaOR97103237100856501(c) 325500Support for Clatsop CC Nursing program
St Joseph the Worker
7528 N Fenwick AvePortlandOR97217931322114501(c) 325500Corporate Internship Program
Adelante Mujeres
2420 19th AveForest GroveOR97116030473181501(c) 325000Produce Rx helping pts with diet related disease
DePaul Industries
4950 NE Marin Luther King Jr BlvdPortlandOR97211930607857501(c) 325000Encourage health lifestyle choices
La Clinica del Valley
3617 S Pacific HwyMedfordOR97501943096772501(c) 325000Support for Kids Health Connection
Self Enhancement Inc
3920 N Kervy AvePortlandOR97227931086629501(c) 325000Student sponsorship, summer celebration
Skanner Foundation
PO Box 5455PortlandOR97228931109980501(c) 316000MLK breakfast sponsorship
Hood River County School District
1011 Eugene StreetHood RiverOR97031936000502501(c) 315782Community health support
Association of Providers for Children
PO Box 40186Glen OakesNY11004453801467501(c) 315000Support of assoc for providers of care for children
Community Action Organization
1001 SW BaselineHillsboroOR97123930554941501(c) 315000Support of prenatal care
Vietnamese Community of Oregon
PO Box 55416PortlandOR97238320263661501(c) 315000Healthcare fair at Tet festival
Oregon Center for Nursing
5000 N Willamette Blvd MSC 192PortlandOR97203743052430501(c) 313500Sponsorship for annual fundraising breakfast
Portland Business Alliance
200 SW Market Suite 150PortlandOR97201320016048501(c) 612750Membership package
Oregon Food Bank
PO Box 55370PortlandOR97238930785786501(c) 311000Food drive donations
Society of St Vincent De Paul
PO Box 42157PortlandOR97242930831082501(c) 310451Community Health Support
Albertina Kerr Center
424 NE 22nd AvenuePortlandOR97232930386780501(c) 310100Sponsorship, Spotlight on Kerr
Cindy Givens Children's Memorial Fund #2372
4465 South Jones BlvdLas VegasNV89103466443350Other10000Donation to childrens trust fund
NAMI Oregon
3550 SE Woodward StreetPortlandOR97202930875209501(c) 310000NAMI NW Walk, mental disability programs
Partners for a Hunger Free Oregon
712 SE Hawthorne Blvd Suite 202PortlandOR97214204970868501(c) 310000Hunger Task Force-Summer Foods program
Trillium Family Services
3415 SE Powell BlvdPortlandOR97202931254344501(c) 310000Mental and behavioral support for children
Lifeworks NW
14600 NW Cornell RdPortlandOR97229930502822501(c) 38500Leadership gift at annual fundraising event
James Bickler Gorge Orthodontics
1625 E 12th StThe DallesOR97058753120828Other7600Donated Dental services
Free Clinic of SW Washington
4100 Plomondon StVancouverWA98661911707542501(c) 37500PCGC 2012 Fall Funding Access to Prim care
Swindells Center at Prov Hood River Hospital
810 12th StreetHood RiverOR97031931265038501(c) 37500Support for grief counseling
Health Care Coalition of Southern Oregon
4286 Pioneer RdMedfordOR97501931065133501(c) 36500Community Health support
Hispanic Metropolitan Chamber
333 SW 5th Ave Suite 100PortlandOR97204931156358501(c) 36183Scholarships, Employment and Business fair
Basic Rights Oregon
PO Box 40625PortlandOR97240931266613501(c) 36000Annual dinner and Auction sponsorship
World Arts Foundation
PO Box 12384PortlandOR97212930830736501(c) 36000Program tribute to "Keep the dream alive"
Centro Cultural of Washington County
PO Box 708CorneliusOR97113930606729501(c) 35100Support of Annual Gala Event
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants55TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations3TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used, along with a report of the number of children/families served over the year.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (32 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John F Koster MD
President/CEO PH&S01257618027944250177690353700029015044525270339126
Jeffrey W Rogers
Corporate Secretary04446460178408057703007350190580943424048099
Todd Hofheins
EVP/CFO03623600175788017577018701021725059615100
Gregory Van Pelt
EVP/OR. Region071702104589010177690411729022710016281300292233
Shelly M Handkins
CFO/OR. Region0381343010128705770281371022796078737400
Michael L Butler
Group President087349505161680163680863387027457022968750435962
Rod Hochman MD
Group President09863100250000020240003070760251010177088700
David T Underriner
CEO/PSA0458799010702401757704088380230220101526000
John V Fletcher
VP/Operations Support0547460010101440177690238549020704018346260388497
Janice J Jones
SVP/CAO059345803705910672070180325023726012353070154703
Myron Berdischewsky MD
SVP/CMQO0496463018280760347690142532024073025259130404844
Cindra R Syverson
SVP/CHRO039697501647080577019723102343707829280130173
Terry L Smith
SVP/Management Svcs.06200950326004066315032685402226501361533069195
Craig L Wright MD
CE/OR. Ambulatory Clin. Svc.0482963029037505770368118023940011659730199302
Ray Williams
SVP/Physician Svcs04918040452500029613101372530257460140343400
Cindy Strauss
SVP/Chief Legal Officer037681001800000650000173813032109082773200
Phil Jackson
VP/Physician Svc. & PMG039391901651180500670134924022765076679300
John O Mudd
SVP/Mission Leadership03590510128263017769094957019393061943300
Claudia Haglund
VP/Governance & Spons.033871501447930175770202296017374072075500
Joel S Gilbertson
VP/Gov't & Public Affairs03372090102148017577084156021411056250100
Joseph Siemienczuk MD
CEO/PMG0344247010724505770123506019966059554100
Janice Burger
CEO/SVMC03013780676700175770214294020842062176100
Orest Holubec
VP/ Communications02790420119255012202033565019919046398300
Debbie Burton
VP/CNO03035180843570175770214734019093063927900
Theron Park
CEO/PPMC0291116067513017577042422020450043907800
Blair D Halperin
Physician - Cardiology5911190563040170000112500225160698189000
Tyler J Gluckman
Physician - Cardiology6715660750000170000112500178800792696000
Daniel S Oseran
Physician - Cardiology5532700938040170000107860213430696203000
Erin J Allen
PMG Dermatology859203000170000170350264850919723000
Walter J Urba
Clin.Research Admin.6365690147736000470180181980849521000
Eugene Al Parrish
Former SVP/RCE Alaska Region083787039984201890049393078120542724056382
John Kenagy
Former VP/CIO07522805185350264911080470676808734890115387

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aThe reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of Providence's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approval by the SVP/Chief Human Resources Officer. During 2012, a total of one first-class ticket was purchased for disclosed personnel. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2012, the following Key Employees received gross-up payments: Arnold R. Schaffer - Relocation Phil Jackson - Relocation Bruce Lamoureux - Gift Card The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. This benefit was discontinued for Calendar Year 2012. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The SVP/Chief Human Resources Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2012, the following Key Employees received relocation/housing program payments: Arnold R. Schaffer Phil Jackson Terry L. Smith Ray Williams The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation.
Part I, Lines 4a-bNONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan d) NQ = Non-Qualified 409(a) Payout 1) John F. Koster, MD a) Taxable SERP Earned but not Paid- $1,872,867 b) SERP Interest Credit - $327,363 2) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,273 b) ESP Interest Credit - $87,150 c) SERP Interest Credit - $136,048 3) Michael L. Butler a) SERP Interest Credit - $301,732 b) SERP Earned but not Vested - $527,516 4) Rod Hochman, MD a) NQ - $202,400 b) SERP Earned but not Vested - $284,676 5) Gregory Van Pelt a) Taxable SERP Earned but not Paid - $183,330 b) ESP Interest Credit - $96,202 c) SERP Interest Credit - $240,115 6) Arnold R. Schaffer a) Taxable SERP Earned but not Paid - $819,315 b) SERP Interest Credit - $157,753 7) John V. Fletcher a) Taxable SERP Earned but not Paid - $511,574 b) Taxable CBRP Earned but not Paid - $5,997 c) ESP Interest Credit - $50,355 d) SERP Interest Credit - $122,030 8) Janice J. Jones a) Taxable SERP Earned but not Paid - $147,676 b) Taxable CBRP Earned but not Paid - $264 c) Non-Taxable SERP Earned - $1 d) SERP Interest Credit - $144,057 9) Myron Berdischewsky, MD a) Taxable SERP Earned but not Paid - $1,522,140 b) Non-Taxable SERP Earned - $43,658 c) SERP Interest Credit - $82,406 10) Michael Hunn a) Taxable SERP Earned but not Paid - $222,462 b) SERP Interest Credit - $44,426 11) Cindra R. Syverson a) SERP Interest Credit - $33,544 b) SERP Earned but not Vested - $148,036 12) Terry L. Smith a) Taxable SERP Earned but not Paid - $68,857 b) Taxable CBRP Earned but not Paid - $673 c) ESP Interest Credit - $67,068 d) SERP Interest Credit - $164,038 13) Craig L. Wright, MD a) SERP Interest Credit - $95,974 b) SERP Earned but not Vested - $241,654 14) Bruce Lamoureux a) Taxable SERP Earned but not Paid - $895,277 b) Taxable CBRP Earned but not Paid - $970 c) Non-Taxable SERP Earned - $1 d) SERP Interest Credit - $47,391 15) Ray Williams a) SERP Earned but not Vested - $119,753 16) Kevin Brown a) NQ - $60,000 b) SERP Earned but not Vested - $114,573 17) Jack Friedman a) Taxable SERP Earned but not Paid - $47,618 b) SERP Interest Credit - $144,595 18) Cindy Strauss a) NQ - $48,000 b) SERP Earned but not Vested - $161,294 19) Phil Jackson a) SERP Interest Credit - $9,748 b) SERP Earned but not Vested - $85,986 20) David T. Brooks a) SERP Interest Credit - $44,009 b) SERP Earned but not Vested - $161,703 21) Medrice Coluccio a) SERP Interest Credit - $55,860 b) SERP Earned but not Vested - $341,617 22) Eugene "Al" Parrish a) Taxable SERP Earned but not Paid - $293,361 b) Non-Taxable SERP Earned - $39,762 23) John Kenagy a) Taxable SERP Earned but not Paid - $417,225 24) Shelly M. Handkins a) DCSERP Interest Credit - $35,757 b) SERP Earned but not Vested - $207,834 25) Janice Burger a) SERP Interest Credit - $163,669 b) ESP Interest Credit - $32,997 26) Joseph Siemienczuk a) SERP Earned but not Vested - $72,374 b) Taxable CBRP Earned but not Paid - $3,337 27) David T. Underriner a) SERP Interest Credit - $251,400 b) SERP Earned but not Vested - $98,115 c) ESP Interest Credit - $34,529 28) Theron Park a) SERP Interest Credit - $2,600 b) SERP Earned but not Vested - $24,563
Part I, Lines 4a-bSEVERANCE 1) John Kenagy - $188,084
Part IIIFORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Performance Awards Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2012, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and quality focused. In 2012 the percent allocation for each of these strategic priorities was: Mission driven 10% Financially responsible 10% People centered 10% Service oriented 10% Quality focused 10%. To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Hospital Facility Authority of Clackamas County
A930847114179027TU12003-05-16213475000Refund Series 1987 & 1992 Bonds & Capital Construction000
Hospital Facility Authority of Multnomah County
B93126628062551PAV92004-07-21104904239Construction of Patient Tower & Parking Structure at PPMC & Child Center000
State of Oregon Oregon Facilities Authority Revenue Bonds
C93600178768608JPT22011-11-1724927615Refund Series 1999 & Adv. Refund Series 2002 & Refunding Series 2005 (WFH)000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindRefunding EscrowRefundingEscrowAmount UnspentAmountUnspent
A13275000213475000579220474811981197261330779320031011
B1564500010490423983109478710380945220070011
C24927615163451824880990200611111197336811973368

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUse
A0000001
B00000010.000000.000000.00000
C00000010.000000.000000.00000

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
NA
A000110000NA001
NA
B000100000NA001
NA
C000000000NA001

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule K Part IV, Arbitrage, Line 2cDate Rebate Computation PerformedIssuer Name: Hospital Facility Authority of Clackamas County Date the Rebate Computation was Performed: 06/30/2008 Issuer Name: Hospital Facility Authority of Multnomah County Date the Rebate Computation was Performed: 09/10/2009
SCHEDULE K, PART III, LINES 2-5FOR HOSPITAL FACILITY OF CLACKAMAS COUNTY, OREGON REVENUE BONDS, SERIES 2003D, SERIES 2003E, SERIES 2003F AND SERIES 2003G (PROVIDENCE HEALTH SYSTEM) The organization allocated proceeds to expenditures according to the accounting method set forth in the Tax Agreement relating to the issue. Under that accounting method, established on the issue date of the issue, any allocations of proceeds to expenditures were for costs reasonably expected, at the time of the allocation, not to be used for a "private business use", not to be used in an "unrelated trade or business" and not to be owned by persons other than the organization. Expenditures made in a manner inconsistent with that accounting method and intention were instead allocated to the next expenditures consistent with that intention that were eligible to be financed with bond proceeds, and which were for property with a remaining economic life at least as long as the remaining economic life of the property identified in the mistaken allocation.
SCHEDULE K, PART III, LINE 8(a-d)FOR HOSPITAL FACILITY OF CLACKAMAS COUNTY, OREGON REVENUE BONDS, SERIES 2003D, SERIES 2003E, SERIES 2003F AND SERIES 2003G (PROVIDENCE HEALTH SYSTEM) The organization is seeking a voluntary closing agreement from the Service with respect to the entry.

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions29NumberOfContributions
Noncash Contribs Rptd F9903353NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionAuction ItemsDescription
Number Of Contributions489NumberOfContributions
Noncash Contribs Rptd F99093623NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used1ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Method for Determining Number of Contributors:Part I, Column (b):The amounts shown on Part I, Col. B reflect the number of donations received of the specific type of item.
Third Party Use:Part I, Line 32b:An auctioneer was hired to sell donated items at the 2012 Monessori School auction conducted Nov 3, 2012.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6The sole Member of the Corporation is Providence Health & Services.
Form 990, Part VI, Section A, line 7aThe powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause.
Form 990, Part VI, Section A, line 7bThe following powers reside with the Corporate Member: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religious significance. 4) To approve the dissolution or liquidation. 5) To approve the annual operating and capital budgets. 6) To appoint the certified public accountants. 7) To approve the closure of any institution or major ministry or work of the Corporation.
Form 990, Part VI, Section B, line 11The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cProvidence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict.
Form 990, Part VI, Section B, line 15It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Human Resources Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Human Resources Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, the President/CEO utilizes the market information provided by the consultant along with formal performance evaluations, to determine salary recommendations for other senior executives. This process includes a rigorous analysis of those recommendations with the Human Resources Committee as a part of the review and approval process. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector.
Form 990, Part VI, Section C, line 19Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon written request. The consolidated Health System financial statements are available on our public Internet site www.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site.
Form 990, Part VIIGregory Van Pelt - 4400 NE Halsey, Bldg. 2, #599, Portland, OR 97213. Shelly M. Handkins - 4400 NE Halsey, Bldg. 2, #599, Portland, OR 97213. David T. Underriner - 4400 NE Halsey, Bldg. 2, #599, Portland, OR 97213. Joseph Siemienczuk MD - 4400 NE Halsey, Bldg. 2, #599, Portland, OR 97213. Janice Burger - 4400 NE Halsey, Bldg. 2, #599, Portland, OR 97213.Contact Addresses for Officers, Directors, Etc
Form 990, Part IX, line 11gAdult Health Services: Program service expenses 17,687,025. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,687,025. Agency Services: Program service expenses 16,363,378. Management and general expenses 1,354,509. Fundraising expenses 0. Total expenses 17,717,887. Ambulance Services: Program service expenses 829,709. Management and general expenses 0. Fundraising expenses 0. Total expenses 829,709. Billing Services: Program service expenses 0. Management and general expenses 1,816,384. Fundraising expenses 0. Total expenses 1,816,384. Consultant Services: Program service expenses 3,667,530. Management and general expenses 5,188,620. Fundraising expenses 0. Total expenses 8,856,150. Emergency Room: Program service expenses 615,113. Management and general expenses 0. Fundraising expenses 0. Total expenses 615,113. Hospital Room and Board: Program service expenses 4,119,427. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,119,427. Imaging Services: Program service expenses 248,142. Management and general expenses 0. Fundraising expenses 0. Total expenses 248,142. Janitorial Services: Program service expenses 4,008,976. Management and general expenses 1,344,445. Fundraising expenses 0. Total expenses 5,353,421. Lab Services: Program service expenses 5,765,990. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,765,990. Laundry Services: Program service expenses 7,549,782. Management and general expenses 91,833. Fundraising expenses 0. Total expenses 7,641,615. Medical Director Fees: Program service expenses 8,159,945. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,159,945. Medical Transcription: Program service expenses 631,031. Management and general expenses 0. Fundraising expenses 0. Total expenses 631,031. Moving Services: Program service expenses 0. Management and general expenses 684,156. Fundraising expenses 0. Total expenses 684,156. Nursing Home Fees: Program service expenses 2,694,222. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,694,222. Other Medical Purchased Services: Program service expenses 16,535,081. Management and general expenses 0. Fundraising expenses 0. Total expenses 16,535,081. Other Non-Medical Purchased Services: Program service expenses 30,760,735. Management and general expenses 91,748,863. Fundraising expenses 0. Total expenses 122,509,598. Personal Care: Program service expenses 212,994. Management and general expenses 0. Fundraising expenses 0. Total expenses 212,994. Physician Fees: Program service expenses 59,504,483. Management and general expenses 0. Fundraising expenses 0. Total expenses 59,504,483. Records Management: Program service expenses 2,915,253. Management and general expenses 57,985. Fundraising expenses 0. Total expenses 2,973,238. Records & Maintenance: Program service expenses 29,623,611. Management and general expenses 8,161,385. Fundraising expenses 0. Total expenses 37,784,996. Security: Program service expenses 0. Management and general expenses 1,920,820. Fundraising expenses 0. Total expenses 1,920,820. Translation Services: Program service expenses 801,802. Management and general expenses 27,683. Fundraising expenses 0. Total expenses 829,485.Other Fees
Form 990, Part XI, line 9:Recipient Organization Adjustments 2,665,147. Capital Asset Equity Transfers -161,745,557. Income on Medical Staff Funds -10,999. Minority Interest Reclassification -251,997. Change in PWFMC Pension Liability -2,386,361.Changes in Net Assets or Fund Balances:
FORM 990, PART I, LINE 6Volunteers contribute to the quality of care for which Providence is noted and exemplify the Providence Mission. Volunteers enhance the patient experience, providing assistance with activities, special projects, greeting, staffing the gift shops, delivery of flowers to patient rooms, running errands, offering clerical support and anything else that is asked of them. Our organization is truly blessed with a wonderful group of volunteers that help each and every day. Volunteer services include but are not limited to the following: * Greeting visitors and patients * Assist patients being admitted/check-in and scheduling * Bond with medically fragile children to add quality of life and joy * Chaplains-providing support for our patients and their families * Clerical support * Deliver flowers to rooms * Deliver incoming and outgoing mail * Give hospital tours * Participate in fundraising and community events * Patient escort * Provide hand crafted items such as hats, booties and blankets for newborns * Provide toy bags for children * Provide information and support for patients/families/visitors * Run errands as needed * Staffing the Gift Shops * Work on special projects for various departments as needed * Assist and support Blood Drives * Help with Blood Pressure clinic * Pet Therapy * Assist nursing and assisted living residents to and from daily activities such as Bingo, Chapel, Game times, Music Programs, Outings, etc. * Provide other support asked of themVOLUNTEERS
FORM 990, PART VIIAs members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community.RELIGIOUS COMMUNITY MEMBERS
Form 990, Part XII, Line 2cThe Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation.AUDIT & COMPLIANCE
SCHEDULE R - RELATED ORGANIZATIONSOn February 1, 2012, Providence Health & Services (the Health System) and Swedish Health Services (Swedish) effected an affiliation Agreement, which integrated the operations of the two health systems. The Health System and Swedish have affiliated to create a fully integrated, nonprofit, charitable health care system serving the communities throughout Western Washington. No cash or other purchase consideration was transferred to effect the affiliation. Effective July 1, 2012, Providence Health System - Southern California entered into an affiliation agreement with Facey Medical Foundation and Facey Medical Group. The Facey Medical Foundation is a nonprofit medical foundation, which operates ten clinics in the North San Fernando, Santa Clarita, San Gabriel and Simi Valleys. These sites are staffed by the Facey Medical Group physicians pursuant to a professional services agreement. No cash or other purchase consideration was transferred to effect the affiliation.AFFILIATION AGREEMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Providence Fairview Properties LLC
1235 NE 47th Avenue Suite 260PortlandOR97213510216587Own & Manage Land for future developmentOR1646195Providence Health & Services - Oregon
Providence Padden Properties LLC
1235 NE 47th Avenue Suite 260PortlandOR97213510216587Own & Manage Land for future developmentOR19305321Providence Health & Services - Oregon

Form990 Schedule R Part II Form990ScheduleRPartII (62 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Providence Health & Services - Washington
1801 Lind Avenue SW 9016RentonWA980579016510216586Healthcare SystemWA501( c)(3)Line 3Providence Health & Services0
Providence Health System - So California
1801 Lind Avenue SW 9016RentonWA980579016510216589Healthcare SystemCA501( c)(3)Line 3Providence Health & Services0
Everett Transitional Care Services
PO Box 5128EverettWA982065128943264605Transitional CareWA501( c)(3)Line 90N/A
Providence Oregon Management Corporation
1801 Lind Avenue SW 9016RentonWA980579016930813977Shell CorporationOR501( c)(3)Line 1PH & S - Oregon0
Providence Plan Partners
4400 NE Halsey Bldg 2PortlandOR97213911861964Healthcare ServicesOR501( c)(4)N/APH & S - Oregon1
Providence Health Plan
4400 NE Halsey Bldg 2PortlandOR97213930863097Health Service ContractorOR501( c)(4)N/AProvidence Plan Partners0
Providence Health Assurance
4400 NE Halsey Bldg 2PortlandOR97213550828701Medicaid Healthcare ProviderOR501( c)(4)N/AProvidence Health Plan0
Providence Medical Institute
4101 Torrance BlvdTorranceCA90503330283773HealthcareCA501( c)(3)Line 11/Type IPHS - So California0
Little Company of Mary Ancillary Services Corporation
4101 Torrance BlvdTorranceCA90503330844408Imaging ServicesCA501( c)(3)Line 9PHS - So California0
Providence TrinityCare Hospice
5315 Torrance Blvd Suite B1TorranceCA90503953264139HospiceCA501( c)(3)Line 9PHS - So California0
Providence Blanchet Association
1700 Providence PlCentraliaWA98531911789266HousingWA501( c)(3)Line 7PH & S - Washington0
St Luke Association
350 Washington Ave SEChehalisWA98352943176618HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Rossi Association
1700 Providence PlCentraliaWA98531311584166HousingWA501( c)(3)Line 9PH & S - Washington0
Lundberg Association
5921 E BurnsidePortlandOR97215911562797HousingOR501( c)(3)Line 7PH & S - Oregon1
Providence St Francis Association
3415 12th Avenue NEOlympiaWA98506943244854HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Peter Claver Association
7101 38th Avenue SouthSeattleWA98118311629656HousingWA501( c)(3)Line 7PH & S - Washington0
Providence St Elizabeth House Association
3201 SW Graham StSeattleWA98126912171539HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Gamelin House Association
4515 MLK Jr Way S Ste 200SeattleWA98108311744654HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Association
312 North Fourth StYakimaWA98901911180824HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Oregon Association
5520 NE GlisanPortlandOR97213911214491HousingOR501( c)(3)Line 9PH & S - Oregon1
The Gamelin California Association
540 23rd StOaklandCA94612911293869HousingCA501( c)(3)Line 9PHS - So California0
Gamelin Washington Association
1423 First AvenueSeattleWA98101201910170HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Foundation
1801 Lind Avenue SW 9016RentonWA980579016943078543Support PH&S InstitutionsWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Alaska Foundation
3300 Providence Drive - B Tower2AnchorageAK99508920093565Support PHS-AlaskaAK501( c)(3)Line 11/Type IPH & S - Washington0
Providence St Peter Foundation
413 Lilly Road NEOlympiaWA985065166911097056Support Affiliated Tax-Exempt OrganizationWA501( c)(3)Line 7PH & S - Washington0
Providence Health Care Foundation (Centralia)
914 S Scheuber RoadCentraliaWA98531911433382Support Providence Centralia HospitalWA501( c)(3)Line 7PH & S - Washington0
Providence Mount St Vincent Foundation
4831 - 35th Avenue SWSeattleWA981262799911188119Support Providence Mount St.VincentWA501( c)(3)Line 7PH & S - Washington0
Providence Marianwood Foundation
3725 Providence Point Drive SEIssaquahWA980297219931554288Support Providence MarianwoodWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Newberg Health Foundation
1001 Providence DriveNewbergOR97132930889144Support Providence Newberg Medical CenterOR501( c)(3)Line 7PH & S - Oregon1
Providence Seaside Hospital Foundation
725 S Wahanna RdSeasideOR97138930927320Support Providence Seaside HospitalOR501( c)(3)Line 7PH & S - Oregon1
Providence Community Health Foundation
1111 Crater Lake AveMedfordOR97504930692907Support Providence Medford Medical CenterOR501( c)(3)Line 7PH & S - Oregon1
Providence Benedictine Nursing Center Foundation
540 South Main StMt AngelOR973629532911940286Support Providence Benedictine Nursing CenterOR501( c)(3)Line 7PH & S - Oregon1
Providence Portland Medical Foundation
4805 NE Glisan StPortlandOR972132967931231494Support Providence Portland Medical CenterOR501( c)(3)Line 7PH & S - Oregon1
Providence St Vincent Medical Foundation
9205 SW Barnes RdPortlandOR97225930575982Support Providence St. Vincent Medical CenterOR501( c)(3)Line 7PH & S - Oregon1
Providence Milwaukie Foundation
10150 SE 32ndMilwaukieOR97222943079515Support Providence Milwaukie HospitalOR501( c)(3)Line 7PH & S - Oregon1
Providence Child Center Foundation
830 NE 47thPortlandOR97213930800140Support Providence Child CenterOR501( c)(3)Line 7PH & S - Oregon1
Providence TrinityCare Hospice Foundation
5315 Torrance Blvd Suite B1TorranceCA90503330261016Support TrinityCare HospiceCA501( c)(3)Line 7PHS - So California0
Providence Little Company of Mary Foundation
4101 Torrance BlvdTorranceCA90503510224944Support Little Company of Mary Service AreaCA501( c)(3)Line 7PHS - So California0
PH&S FoundationSFVSA & SCVSA
501 S Buena Vista StreetBurbankCA91505953544877Support Program & Activities of SFVSA & SCVSACA501( c)(3)Line 7PHS - So California0
Providence Hospice of Seattle Foundation
425 Pontius Avenue North 300SeattleWA981095452912077378Support Hospice of SeattleWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Health & Services - Western Washington
1801 Lind Avenue SW 9016RentonWA980579016911303277HealthcareWA501( c)(3)Line 3Providence MinistriesWHC0
Providence Health & Services
1801 Lind Avenue SW 9016RentonWA980579016911549796Shell CorporationWA501( c)(3)Line 11/Type I0N/A
Providence Health & Services - Montana
500 W Broadway PO Box 4587MissoulaMT598064587810231793HealthcareMT501( c)(3)Line 3PH & S - Washington0
Providence St Joseph Medical Center
PO Box 1010PolsonMT598601010810463482HealthcareMT501( c)(3)Line 3PH & S - Washington0
St Thomas Child and Family Center
1710 Benefis CourtGreat FallsMT59405810233495Early Childhood EducationMT501( c)(3)Line 1PH & S - Washington0
Sisters of Providence of Montana Corporation
1801 Lind Avenue SW 9016RentonWA980579016262612415Shell CorporationMT501( c)(3)Line 1PH & S - Washington0
Providence Health Care Foundation - Eastern Washington
101 W 8th AveSpokaneWA99204320014330Support PH&S-WA. Ministries in E. WA.WA501( c)(3)Line 7PH & S - Washington0
St Patrick Hospital Foundation
500 West Broadway PO Box 4587MissoulaMT598064587237056976Support Healthcare in W. MontanaMT501( c)(3)Line 7PH & S - Washington0
University of Great Falls
1301 20th Street SouthGreat FallsMT59405810231777Post Secondary EducationMT501( c)(3)Line 2PH & S - Washington0
E WA & MT Unemployment Compensation Insurance Trust
1801 Lind Avenue SW 9016RentonWA980579016911082119Unemployment BenefitsWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Willamette Falls Medical Foundation
1500 Division StreetOregon CityOR97045931003750Support Willamette Falls HospitalOR501( c)(3)Line 11/Type IPH & S - Oregon1
Providence Hood River Memorial Hospital Foundation Inc
811 13th StHood RiverOR97031930921990Support Providence Hood River Memorial HospitalOR501( c)(3)Line 7PH & S - Oregon1
Providence Hospice and Home Care Foundation
2731 Wetmore Avenue Suite 500EverettWA98201272552749Support Program & Ministries of PHHCWA501(c )(3)Line 7PH & S - Washington0
Providence St Mary Foundation
401 W Poplar StWalla WallaWA99362452841492Support Program & Ministries of SMMCWA501(c )(3)Line 7PH & S - Washington0
Facey Medical Foundation
15451 San Fernando Mission Blvd 200Mission HillsCA913451420954322584Support Facey Medical GroupCA501(c )(3)Line 7PHS - So California0
Swedish Health Services
747 BroadwaySeattleWA98122910433740HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Edmonds
21601 76th Ave WEdmondsWA98026272305304HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Medical Center Foundation
747 BroadwaySeattleWA98122910983214Support Swedish Health ServicesWA501(c )(3)Line 7Swedish Health Services0
Global To Local Health Initiative
747 BroadwaySeattleWA98122273133200HealthcareWA501(c )(3)Line 7Swedish Health Services0
Swedish MJM Holdings
747 BroadwaySeattleWA98122273139262Holding CompanyWA501(c )(3)Line 11/Type ISwedish Health Services0
Marsha Rivkin Center for Ovarian Cancer Research
747 BroadwaySeattleWA98122912054035Ovarian Cancer ResearchWA501(c )(3)Line 7Swedish Health Services0
Western HealthConnect
747 BroadwaySeattleWA98122454171900Shell CorporationWA501(c )(3)Line 11/Type IProvidence Ministries0

Form990 Schedule R Part III Form990ScheduleRPartIII (28 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Providence Imaging Center
3340 Providence DriveAnchorageAK99508920118807Medical ImagingAKPH&S - WARelated00
Pathology Associates Medical Laboratories LLC
611 N PerrySpokaneWA99202270943279Outpatient LabWABourget Health Services IncRelated00
California Laboratory Associates LLC
501 Buena VistaBurbankCA91505273888692Outpatient LabCAPHS - So CaliforniaRelated00
Surgery Ctr at Tanasbourne LLC
1235 NE 47th Ave 260PortlandOR97213208187971Ambulatory Surgery CenterORPH&S - ORRelated0051613330540560.83400
Distribution Operations Center LLC
1801 Lind Ave SW 9016RentonWA98057271054858Supplies Purchasing AgentWAPH&S - WARelated00
Broadway Imaging LLC
500 W BroadwayMissoulaMT59802522405971Medical ImagingMTPH&S - MTRelated00
Ctr for Med Imaging-Bridgeport LLC
1235 NE 47th AvePortlandOR97213260796953Imaging - DiagnosticsORPH&S - ORRelated005022912869970.75000
Ctr for MedImaging-Tanasbourne LLC
1235 NE 47th AvePortlandOR97213200477972Imaging - DiagnosticsORPH&S - ORRelated0073181814813450.75000
Portland Medical Imaging LLC
10538 SE Washington StPortlandOR97216201054971Imaging - DiagnosticsORPH&S - ORRelated0019507217443730.75000
Oregon Advanced Imaging LLC
881 OHare ParkwayMedfordOR97504450471748Medical ImagingORPH&S - ORRelated00177815755249880.70000
Minor & James Medical PLLC
515 Minor Avenue 200SeattleWA98104911340223Physician ClinicWASwedish MJM Holdings IncN/A00
Clackamas Radiation Oncology Center LLC
1235 NE 47th Ave 288PortlandOR97213260381897Radiation OncologyORPH&S - ORRelated0066106917455210.67000
PETCT Imaging at Swedish Cancer Institute LLC
1221 Madison StreetSeattleWA98104203132044Medical ImagingWASwedish Health ServicesRelated00
Mountainstar Clinical Laboratories LLC
611 N PerrySpokaneWA99202261345983Outpatient LabMTPAML LLCRelated00
PacLab LLC
611 N PerrySpokaneWA99202911743952Outpatient LabWAPH&S - WARelated00
Center for Specialty Surgery LLC
11782 SW Barnes RdPortlandOR97225263638838Ambulatory Surgery CenterORPH&S - ORRelated0078788528045640.51000
Oregon Outpatient Surgery Center
7300 SW Childs RdTigardOR97224223883387Ambulatory Surgery CenterORPH&S - ORRelated0087384713148670.51000
ProvidenceUSP Santa Clarita GP LLC
11550 Indian Hills Road 160Mission HillsCA91345202829660Ambulatory Surgery CenterCAPHS - So CaliforniaRelated00
ProvidenceUSP Surgery Ctrs LLC
11550 Indian Hills Road 160Mission HillsCA91345200905938Ambulatory Surgery CenterCAPHS - So CaliforniaRelated00
Alpha Medical Laboratory LLC
611 N PerrySpokaneWA99202912017347Outpatient LabIDPAML LLCRelated00
Canby Medical Center I LLC
2747 Pence Loop SESalemOR97302205470937Real Estate - MOBORPH&S - ORRelated001084928191140.50000
Greater Valley Medical Building LP
501 S Buena Vista StBurbankCA91505954570858Real Estate - MOBCAPHS - So CaliforniaInvestment00
Medalia Healthcare LLC
1801 Lind Ave SW 9016RentonWA98057911660459Physician BenefitsWAPH&S - WAInvestment00
Prov Radiation Oncology Develop Assn LLC
1235 NE 47th AvePortlandOR97213260682491Real Estate - MOBORPH&S - ORInvestment00-13424836956500.50000
ProvidenceSilverton Rehab LLC
1235 NE 47th Ave 260PortlandOR97213481287267Rehab ServicesORPH&S - ORRelated00-59507721690.50000
Southern Idaho Regional Laboratory LLC
611 N PerrySpokaneWA99202820511819Outpatient LabIDPAML LLCRelated00
Tri-Cities Laboratory LLC
611 N PerrySpokaneWA99202911773986Outpatient LabWAPAML LLCRelated00
Providence Partners for Health LLC
501 S Buena Vista StBurbankCA91505454041798Clinical Quality & IntergrationCAPHS - So CaliforniaRelated00

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
Providence Health Ventures Inc
4101 Torrance BlvdTorranceCA90503330122216InvestmentCAN/AC0
Caron Health Corporation
510 W Front StMissoulaMT59802810486082Medical Physician ServiceMTN/AC0
Providence Health Care Ventures Inc
101 W 8th Ave TAF C-9SpokaneWA99204900155714Clinical/Medical LabWAN/AC0
Providence Physician Services Co
101 W 8th Ave TAF C-9SpokaneWA99204911216033Clinical/Medical LabWAN/AC0
Yakima Medical Arts Inc
611 N Perry 100SpokaneWA99202910787963Rental Real EstateWAN/AC0
Bourget Health Services Inc
PO Box 2687SpokaneWA99220911354431Clinical/Medical LabWAN/AC0
1221 Madison Street Owners Assoc
747 BroadwaySeattleWA98122201954319Owners' AssociationWAN/AC0
Washington Cancer Centers PC
1560 N 115th G-16SeattleWA98133911792791Cancer TreatmentWAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (30 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Providence Benedictine Nursing Center Foundation
C177841Cost
Providence Benedictine Nursing Center Foundation
B151551Cost
Providence Benedictine Nursing Center Foundation
Q149000Cost
Providence Child Center Foundation
C1604137Cost
Providence Child Center Foundation
B415911Cost
Providence Child Center Foundation
Q417468Cost
Providence Community Health Foundation
C565168Cost
Providence Community Health Foundation
B332530Cost
Providence Hood River Memorial Hospital Foundation
C36505Cost
Providence Hood River Memorial Hospital Foundation
B150456Cost
Providence Milwaukie Foundation
C99600Cost
Providence Milwaukie Foundation
B222679Cost
Providence Newberg Foundation
C247946Cost
Providence Newberg Foundation
B250316Cost
Providence Portland Medical Foundation
C6199958Cost
Providence Portland Medical Foundation
B575997Cost
Providence Seaside Foundation
C230346Cost
Providence Seaside Foundation
B110961Cost
Providence St Vincent Medical Foundation
C7093203Cost
Providence St Vincent Medical Foundation
B696129Cost
Providence Willamette Falls Foundation
C59890Cost
Providence Willamette Falls Foundation
B123081Cost
Providence Plan Partners
O63404491Cost
Providence Plan Partners
Q17341621Cost
Providence Plan Partners
J5255388Cost
Providence Health Plan
Q859496Cost
Providence Health Assurance
Q190197Cost
Oregon Outpatient Surgery Center
A680858Cost
Central Point MRI LLC
A354900Cost
Center for Medical Imaging LLC
B87525Cost

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.